Genital Urinary System

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Genital Urinary System

• Female Reproductive System

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Behavioral Objectives

• Review the anatomy and physiology of the female
  GU systems
• Describe the physical assessment of the female GU
  systems
• Discuss the application of the nursing process as
  it relates to patients with disorders of the
  female GU system
• Describe etiology, pathophysiology, clinical
  manifestations, nursing management and patient
  education for the following female GU disorders
• Vaginitis
• Pelvic inflammatory disease (PID)
• Endometriosis
• Discuss incidence, prevention tx of the pts
  with CA of the GU system
• Discuss the nursing interventions in pre and
  post-operative care of patients undergoing the
  following surgeries
• Hysterectomy
• Mastectomy

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• Brunner and Suddarths Medical Surgical Nursing
• Text Ch. 46-48

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Anatomy Review Internal Reproductive Structures

• Vagina
• Mucus membrane
• Posterior to bladder urethra
• Anterior to rectum
• Anterior posterior walls touch
• Upper vagina surrounds cervix
• Inferior uterus

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Anatomy Review Internal Reproductive Structures

• Uterus
• Pear-shaped
• Muscular
• Size
• ?
• Variable
• pg

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Anatomy Review Internal Reproductive Structures

• Location
• Posterior to bladder
• Ligaments

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Uterus

• Two parts of the uterus
• Cervix
• Projects into the Vagina
• Fundus
• Body of the uterus
• Endometrium
• Lining of the uterus

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Anatomy Review Internal Reproductive Structures

• Ovaries
• Connected to uterus by the fallopian tubes
• Contains
• 1000s of ova _at_ birth
• Ova / Ovum
• Egg cells (immature)
• Ova plural
• Ovum - Singular

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Physiology Review
Start

• Ovulation
• Definition
• Discharge of a mature ovum from the ovary

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Physiology Review
Start

• Ovulation
• Follicular Stage
• Ovum enlarges ? cyst (graafian follicle)
• Reaches the surface (of the ovary)
• Ovum is discharged
• Ovulation

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Physiology Review After Ovulations

• Ovum?
• Fallopian tube ?
• Uterus
• IF is meets a spermatozoon
• Union conception
• Location of fertilization?

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Physiology Review After ovulation

• Ovum cyst ?
• Corpus luteum
• Stays in the ovary
• Produces progesterone
• Prepares the uterus for the fertilized ovum

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The Menstrual Cycle

• 2 system control menstruation process
• Reproductive
• Endocrine Hormones

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The Menstrual Cycle

• Ovaries ?
• Estrogen
• Progesterone

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The Menstrual Cycle

• Pituitary gland
• FSH
• Stim. Ovaries
• to secrete estrogen
• LH
• Stim. Progesterone ?
• Ovulation

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The Menstrual Cycle

• Cyclic pattern ?
• Changes in the endometrium and menstruation
• 28 day cycle

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Menopausal Period

• End of reproductive capacity
• Age 45 52 yrs
• Menstruation ceases

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Menopausal Period

• Ovaries not active ?
• _?__ estrogen
• i
• Reproductive organs i size
• No ova mature

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Physical assessment

• Health history
• Menstrual hx
• Menarche
• Beginning of menstruation
• Length
• Amount
• Cramps/pain ?
• Hx of pregnancies
• Medication Hx

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Assessment History Clinical Manifestations

• Pain
• Dysmenorrhea
• Dyspareunia
• Hx vaginal discharge
• Odor
• Itching
• Hx urinary functions
• Hx BB control

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Assessment History Clinical Manifestations

• Sexual history
• History of sexual or physical abuse
• History of surgery
• History of chronic illness or disability
• History of genetic disorders

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• Physical Exam
• Breast
• Frequency
• Monthly

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Physical Assessment

• Pelvic
• Frequency
• Annual
• Initial
• gt age 18
• sexually active
• breast
• pelvic
• Positioning
• Supine lithotomy position

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Physical Assessment

• Inspection
• Inspects external genitilia
• Speculum examination
• Vaginal canal
• Cervix

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Physical Assessment

• Pap smear
• Tissue sample of cervix ?
• Purpose
• Dx Cervical Ca
• No douche before visit

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Physical Assessment

• Bimanual palpation
• Cervical palpation
• Uterine palpation

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• Colposcopy
• Portable microscope
• Obtain sample

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